Holiday Request Form

APPLICATION FOR ABSENCE FROM SCHOOL: HOLIDAY / EXTENDED LEAVE

It is a legal requirement for parents/carers to obtain the permission of the Headteacher before removing their child from school in order to take a holiday during term time. Parents do not have an automatic right to take their children out of school for holidays during term time and may be issued with a Penalty Notice (£100 per parent per child) if they do so without prior arrangement with the Headteacher.

Parents wishing to apply for their child to be granted leave from school should complete this form and return it to school for consideration before booking and well in advance of the proposed leave. Upon receipt of a request the Headteacher will make a decision as to whether to authorise the absence, being mindful of government regulations and LA guidance. The legislation only allows the Headteacher to authorise such leave in special or exceptional circumstances. By definition, special or exceptional trips should not occur regularly. Therefore, it is not expected that holiday leave will be requested on an annual basis.

For leave of more than 10 school days in duration, or when school have concerns about the leave request, the Headteacher or their representative will arrange to meet with you to discuss your application. Please see overleaf for factors that will be taken into account by school when considering a request for leave.

PARENTS’ SECTION

(Please attach additional sheets if necessary)

Please complete all parts of this form and return to St. Andrew’s School
Surname of child: First Name of child:
Date of Birth: Year Group:
Surname of parent/carer: First name:
Relationship to child: Are there any siblings applying for leave?
Home address:
Postcode: Telephone number:
   
Please state why leave must be taken during term time instead of during school holiday periods
       
Length of absence :

(number of days in school)		 Destination:
       
Date of departure: Date due back in school:
       
Emergency UK telephone contact name and number: Other emergency contact details, if leave is outside the UK
       
Number:: the UK:
 
Employer Details

If you are stating work commitments as a reason for requesting leave, please complete this section and attach any evidence you have showing why leave cannot be taken during the school holidays.

Name:
Address
Telephone:
       
Parent/carer's signature: Date of Application:

FACTORS FOR CONSIDERATION

Pupils attend school for a maximum of 190 days each academic year. Regular attendance is vital for your child's educational progress. The Local Authority expects that all parents/carers ensure their children attend school whenever possible. Absence during school time hinders academic progress. The following factors should be taken into account when considering an application for leave:

  • Will leave at this point in time be detrimental to the pupil's education?
  • Will he/she miss any national tests or examinations?
  • Is his/her attendance already below 90% or a previously agreed target?
  • Is the proposed absence during the month of September or any other transition period?
  • Has he/she already had leave during term time this year?
  • Did he/she have leave of absence during term time in the previous school year?
  • Does he/she have any absences which have been recorded as unauthorised this year?

SCHOOL SECTION:

Date application received: Pupil's % Attendance:
Date of meeting with parent(s): (if applicable) SIMS/STAR ethnicity code:
Gender of child:
Male
Female
About the request:

(Please circle)
Leave request approved?



Yes



No
Parent(s) informed of potential

consequences of taking unauthorised leave



Yes



No
Is leave in excess of 10 days?



Yes



No
Parent(s) informed of potential consequences of failure to return on due date?



Yes



No
Reason(s) for decision:    
Number of previous applications granted:    
Headteacher's signature: Date:
Parent/carer's signature: Date of Application:

Please return a copy of this form to the parent/carer after consideration

In cases where leave has been authorised by the school, parents/carers may wish to keep this letter of authorisation with them as evidence if they are challenged by an attendance/police officer during a truancy sweep.